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How Older Individuals Can Manage Hip Pain  

15 Sep

Hip pain is a condition that becomes more common with age. It’s reported that 1 in 7 seniors experience significant hip pain on most days, particularly with simple movements such as sitting and standing. In addition to being painful, these individuals are also likely to report a diminished ability to carry out their regular activities. As such, it’s not unusual for a hip pain sufferer to schedule a visit with a doctor of chiropractic to see if a conservative course of care can benefit them without the need for medications, injections, or surgical intervention.

When a patient first presents for chiropractic care for hip pain, they will be asked to complete paperwork to describe both their past medical history and their current hip pain. This may also include questionnaires using diagrams and scales to assess pain and disability. The information provided will be useful to rule out red flags (fracture, infection, malignancy, and/or acute nerve injury) that may necessitate referral to a specialist or emergency services. The data will also provide insights as to the potential cause/s of the patient’s hip pain. 

The possible causes for hip pain are myriad. In addition to trauma, arthritis, congenital defects, and other issues that can affect the soft tissues and bones that comprise the hip joint, the pain experienced as “hip pain” may actually be referred pain from the low back or buttocks. Or the patient might not even have hip pain but may be mistaking pain from nearby locations as hip pain. There may even be indication that the underlying cause is not musculoskeletal in nature and part of a larger issue that may need to be co-managed with the patient’s medical physician. 

Once a chiropractor has reviewed the information provided by the patient, they will conduct a physical examination of the hip joint that may include analysis of gait or walking, sitting, and standing; ability to stand on one leg; range of motion (ROM) from seated and recumbent positions; leg length variance; muscle length checks; and neurovascular assessments in the lower limbs. This may also involve evaluation of the feet, ankles, knees, and lower back, as musculoskeletal disorders in these areas can place added stress on the affected hip during movement and would need to be treated to provide a satisfactory outcome for the patient.

While the specifics of treatment will vary from patient to patient, as well as the chiropractor’s training and clinical experience, care may involve a multimodal approach that includes manual therapies, exercise training, nutrition recommendations, and physiotherapy modalities aimed at restoring normal movement to the hip and other joints that could play a role in the patient’s chief complaint. As with many conditions, the longer it persists, the more time it can take to achieve a complete recovery, if at all. If you’re currently experiencing hip pain, call your doctor of chiropractic sooner rather than later. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Can Hip Osteoarthritis Be Prevented?

20 Jun

Hyaline cartilage is the slick, translucent tissue that lines joint surfaces and allows for the smooth movement of joints in the body, including the hip. If the structure or health of this cartilage is compromised, it can gradually wear away, leading to joint pain, stiffness, and disability. Eventually, the hip osteoarthritis patient may have no choice but to accept a dramatically reduced lifestyle or undergo total hip arthroplasty. Is it possible to prevent osteoarthritis of the hip or at least slow its progression?

Unfortunately, the answer isn’t a firm yes or no. There appears to be a genetic component to osteoarthritis risk, so you may be destined for the condition. However, it does appear that if you manage to avoid major trauma to the hip and stay physically active and otherwise live a healthy lifestyle, then it may be possible to significantly reduce the risk for developing the condition and requiring surgical intervention. 

Between 2014 and 2017, researchers in Germany conducted a study in which nearly 24,000 patients with either hip or knee osteoarthritis received usual care or participated in a structured program focused on guidelines-recommended therapies and patient empowerment, including lifestyle changes and exercise interventions. Patients in the experimental group were 33.6% less likely to be hospitalized or undergo joint replacements related to their knee/hip. 

 Chiropractic care offers a unique opportunity for patients as the initial history typically includes a comprehensive review of systems including all aspects of health, both past and present. This approach often extends care well past the primary presenting complaint (hip pain, in this case) to include patient education regarding diet/nutrition, stress management, sleep quality enhancement, and more. Additionally, a doctor of chiropractic will assess related areas of the body to identify problems that can affect normal movement patterns (the foot, ankle, knee, pelvis, low back) as addressing these issues may be critical to help the patient achieve a satisfactory outcome.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

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Preventing Shoulder Injuries in Athletes

25 May

Shoulder injuries are common in athletes, especially those requiring overhead repetitive movements at high velocity and extreme range of motion. For example, shoulder injuries account for 19% of injuries to baseball players and nearly 40% of injuries to swimmers. Because a shoulder injury can sideline an athlete and even prematurely end their season, a current trend in sports medicine is to find ways to prevent shoulder injuries in the first place.

A systematic review conducted in 2022 looked at 25 studies conducted between 1970 and 2018 to uncover common risk factors for shoulder injuries among athletes from a variety of sports including volleyball, handball, basketball, swimming, water polo, badminton, baseball, and tennis. In the final analysis of the review, the authors concluded that prevention programs should focus on strengthening the rotator cuff muscles and maximizing shoulder range of motion. 

In fact, another literature review found that a pre-season range of motion evaluation may help identify athletes at risk for a shoulder injury during the coming season. The review included 15 studies involving a total of 3,313 collegiate or Olympic athletes from sports with overhead shoulder movements such as baseball and swimming. The results indicated that the risk for shoulder injury was greatest for swimmers whose external shoulder rotation range of motion fell outside of the 94-degree to 99-degree range. For baseball players, especially pitchers, an external shoulder range of motion difference between the throwing and non-throwing arm below five degrees was associated with a two-fold greater risk for shoulder and/or elbow injury. 

As the saying goes, prevention is the best medicine. So if you participate in sports that include overhead movements, schedule an appointment with your doctor of chiropractic before the season starts so they can evaluate you to uncover any current conditions that may lead to issues during competition as well as instruct you on ways to augment your pre-season training regimen to maximize the function of your shoulder, including its external range of motion.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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Chiropractic Care for Lateral Ankle Sprains

30 Apr

Most people have rolled an ankle in their lifetime.  Usually, an ankle sprain heals without any consequence, but that isn’t always the case. According to the current research, a third or more of lateral ankle sprain patients may experience long-term problems like ankle instability that necessitates splinting or taping the ankle before engaging in sports or other weight-bearing physical activities. Can chiropractic care help reduce the risk of ankle instability and other chronic issues that can arise from a lateral ankle sprain?

In 2022, researchers conducted a systematic review and meta-analysis of data from three studies that included 180 patients to assess the effectiveness of manual therapy and/or exercise in the management of lateral ankle sprains. The type of manual therapies used in the three studies included non-thrust mobilization, thrust manipulation, and myofascial release methods—all techniques utilized by chiropractors on a daily basis. The exercises focused on proprioception (balance oriented), stretching, and strengthening. 

The research team observed that the combination of manual therapy and exercise is more effective than exercise alone in improving ankle ranges of motion, lower limb function, and pain, leading them to conclude that the addition of manual therapy to lateral ankle sprain treatment will improve clinical outcomes. In addition to reducing the risk for ankle instability, lateral ankle sprain patients who receive manual therapy may also have a lower risk for reduced thickness of the plantar fascia, reduced cross section size (atrophy) of the peroneus brevis muscle, and altered activation patterns of select lower limb muscles, which may significantly reduce their risk for reinjury. This can be very important for rugby, tennis, football, volleyball, and basketball athletes as ankle-related issues affect roughly half of participants in these sports.

Chiropractic colleges educate students on the application of manual therapies to the upper and lower extremities. Additionally, many post-graduate programs offer continuing education courses on the same topic. The next time you, a family member, or friend suffers an ankle sprain, be sure to consider chiropractic care. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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Chiropractic Therapy for Hip Pain and Function

25 Mar

Each year, surgeons perform hundreds of thousands of total hip arthroplasties (hip replacements), and the most common reason is osteoarthritis of the hip. This condition isn’t caused by an underlying disease, rather it’s due to wear and tear of the hip joint from everyday activities over time. Not only can osteoarthritis of the hip be painful, but it can reduce the range of motion of the joint, making it difficult to move around. Most patients seek to avoid or delay surgery as much as possible, which drives many to seek chiropractic care. The question is: what can a doctor of chiropractic do to manage osteoarthritis of the hip?

Doctors of chiropractic receive training in the application of several manual therapies of varying force, depending on the condition, patient preferences, and the practitioner’s clinical expertise. In one study that included 60 hip osteoarthritis patients, researchers used a technique called long-axis distraction mobilization (LADM) at varying levels of force and found that high-force LADM yielded superior results with respect to range of motion of the hip joint, although low- and medium-force treatment led to similar improvements in pain. 

A follow-up study by the same researchers with another group of 60 hip osteoarthritis patients found that low-force LADM performed better with respect to reducing pain sensitivity in the hip as well as the low back and knees. On the other hand, high-force LADM brought greater improvements in overall function. A systematic review from 2022 that included ten studies found that the combination of LADM with thrust manipulation and mobilization with movement (two-to-three treatments a week for two-to-six weeks) can provide even larger improvements with respect to pain and range of motion.

When managing a patient with musculoskeletal pain, chiropractors will often use a combination of several approaches—a multimodal approach—to achieve the best possible outcomes with respect to pain and function. This includes manual therapies, specific exercises, physiotherapy modalities, nutritional recommendations, and more. In addition to treatments directed at the hip itself like those listed above, doctors of chiropractic will also assess the motion of the joints in the lower back, knees, and ankle as abnormal mechanics in these areas can put added stress on the hip and affect recovery. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

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The Hip-Foot Connection

15 Jun

When examining a patient for hip pain and other musculoskeletal conditions, doctors of chiropractic will expand their focus beyond the area of chief complaint to identify issues elsewhere in the body that may be underlying or contributing factors. This is especially true with the hip because anything that affects normal locomotion can lead to compensatory changes and abnormal motion in the hip joint, which can easily result in inflammation or wear and tear that causes pain. Such is the case with issues in the foot, like plantar fasciitis.

Plantar fasciitis is one of the most common causes of heel pain and is characterized by inflammation of the thick band of tissue (plantar fascia) located on the bottom of the foot that connects the heel bone (calcaneus) to the toes. Individuals with the condition may experience a stabbing pain that often occurs with initial weightbearing, especially in the morning. The intense initial pain usually improves after a few steps; however, it can also worsen following prolonged standing or intense activity.

The function of the medial longitudinal arch of the foot is to absorb shock and to add “spring” to each step. In the mid-stance phase of gait, the arch flattens out, stretching the plantar fascia (the “string”) and if stress and tension exceeds the tissue’s threshold or becomes too great, micro-tears inflame the fascia and cause pain when initiating weightbearing. This leads to pain and can affect normal gait, which can ultimately lead to issues up the kinetic chain, such as hip pain.

Risk factors for PF include advancing age, stressful exercise (running, ballet dancing, aerobic dance), altered arches in the feet (such as flat feet as well as a high arch), obesity, and occupations that require an individual to be on their feet all day, especially on hard surfaces.

Following diagnosis, which may include a review of the patient history and an examination, a conservative treatment approach in a chiropractic setting may include manual therapies (longitudinal and cross fiber friction massage); Graston technique (using spoon-like tools to stimulate blood flow and break up adhesions); stretching exercises (calf stretches off a step or using TheraBand to bend the foot and ankle upwards and extend the toes); prescription foot orthotics with pronation correction (lateral heel wedge); modalities (laser, ultrasound, extracorporeal shock wave therapy); and dorsiflexion night splinting. Patients may also be encouraged to reduce their intake of processed foods—which can increase inflammation in the body—and eat a more anti-inflammatory diet, like the Mediterranean diet, to aid in the healing process.

Because prolonged standing and stressful exercise can worsen the condition, patients may be advised to reduce the time they spend on their feet and switch to less impactful forms of exercise during recovery. The good news is that conservative treatment approaches, such as chiropractic care, are often successful in helping PF patients manage their condition.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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